State of Tennessee Group Insurance Program New Employee

State of Tennessee Group Insurance Program New Employee Benefits Orientation State and Higher Education Employees January 1 – December 31, 2016

Importance of Your Decisions • The decisions you make now as a new employee will have lasting effects on your benefits • Please note: Some decisions can only be made during the new hire period • Be aware of all the options available to you and make an informed decision • Submit questions to your Agency Benefits Coordinator (ABC) www. partnersforhealthtn. gov 1 -800 -253 -9981 1

Resource Materials For more detailed information, refer to the Eligibility and Enrollment Guide provided by your ABC. You will also be provided with an Employee Checklist to confirm that you have been informed of important benefits information. www. partnersforhealthtn. gov 1 -800 -253 -9981 2

Resource Materials tn. gov/finance/section/fa-benefits The Summary of Benefits Coverage (SBC) describes your health coverage options. You can print a copy on the Benefits Administration website, or ask your ABC for a copy. www. partnersforhealthtn. gov 1 -800 -253 -9981 3

About the Plan • The State Group Insurance Program (the Plan) covers: • State and Higher Education Employees • Local Government Employees • We spend about $1. 3 billion annually and cover nearly 300, 000 members • The health plan is self-insured. The State, not an insurance company, pays claims from premiums collected from members and their employers • The Division of Benefits Administration manages the Plan. www. partnersforhealthtn. gov 1 -800 -253 -9981 4

Who is Eligible for Coverage? • Full-time employees and their dependents, who may include: • Legally married spouses • Children up to age 26, (natural, adopted, step-children or children for whom the employee is the legal guardian) • Special circumstances for disabled dependents may allow for coverage after age 26. Refer to Eligibility and Enrollment Guide or consult your ABC for more information. • Employees cannot be enrolled in Tenn. Care and a State Group Health Insurance Plan • Contact your caseworker at Tenn. Care within 10 days of your date of employment to report your new job, salary and that you have access to medical insurance with your new employer www. partnersforhealthtn. gov 1 -800 -253 -9981 5

Adding Coverage Three times you may add health coverage: 1. As new employee 2. Annual Enrollment in the fall 3. If you experience a special qualifying event Ø A special qualifying event could be marriage, birth of a baby or something that results in loss of other coverage Ø Submit the enrollment within 60 days of the event or loss of other coverage Ø A complete list is provided on page three of the enrollment application www. partnersforhealthtn. gov 1 -800 -253 -9981 6

Annual Enrollment • During Annual Enrollment you may: • • Enroll, cancel or make changes to health insurance Select or change your health insurance carrier Choose or switch CDHP/PPOs (subject to eligibility) Enroll in, cancel or transfer between dental options Enroll in, cancel or transfer between vision coverage Enroll in or cancel optional accidental death coverage Apply for, cancel, increase or decrease optional term life coverage amounts (if eligible) • Changes are effective January 1 of the following year Annual Enrollment occurs during the fall www. partnersforhealthtn. gov 1 -800 -253 -9981 7

Canceling Coverage • You may only cancel health, dental or vision coverage for yourself or your dependents: 1. During Annual Enrollment 2. If you become ineligible to continue coverage 3. If you and/or your dependents become newly eligible for coverage under another plan due to an event like marriage, divorce, birth or adoption of a child. www. partnersforhealthtn. gov 1 -800 -253 -9981 8

Definitions • Premiums - amount you pay each month for your coverage regardless of whether or not you receive health services • Copay - flat amount you pay for services and products (office visits. Prescriptions etc. ) • Deductible - set amount you must pay each year for services • Coinsurance - % of cost for a service after you meet deductible www. partnersforhealthtn. gov 1 -800 -253 -9981 9

Definitions • Out-of-pocket maximum - limit on amount you pay each year in deductibles, co-insurance and copays • Network - group of doctors, hospitals and other providers contracted with a health insurance plan to provide services to members at pre-negotiated (usually discounted) fees • Maximum allowable charge (MAC) - the most a plan will pay for a service For a complete list of definitions, see the Eligibility and Enrollment Guide or visit our website. www. partnersforhealthtn. gov 1 -800 -253 -9981 10

What is ALEX? ALEX is a smart, funny benefits expert who explains benefits options and may help members choose what’s best for them. Go to www. partnersforhealthtn. gov 11

Choosing Your Health Insurance Options Plan Options Partnership PPO Insurance Two Carriers Premium Four Levels (tiers) Standard PPO • Blue. Cross Blue. Shield of Tennessee • Employee Wellness Health. Savings CDHP • Cigna • Employee + spouse • Employee + child(ren) • Employee + spouse + child(ren) Health. Savings CDHP After your new hire period, changes can only be made if you experience a special qualifying event or during Annual Enrollment in the fall. *COBRA participants and retirees are not eligible for the Wellness Health. Savings CDHP. www. partnersforhealthtn. gov 1 -800 -253 -9981 12

Health Benefits Preferred Provider Organizations (PPOs) • Partnership PPO and Standard PPO • Offer same services and treatments • Pay less in copays and coinsurance with the Partnership PPO versus the Standard PPO • Pay deductible first before coinsurance applies • Separate out-of-pocket maximums for medical and pharmacy • Pay for prescriptions with copays • When out-of-pocket maximum is reached the plan pays 100% for in-network services www. partnersforhealthtn. gov 1 -800 -253 -9981 13

Health Benefits Health. Savings CDHPs 1. Wellness Health. Savings CDHP – must complete the Partnership Promise and the state will put $500 for employee coverage or $1, 000 for family coverage into your HSA* 2. Health. Savings CDHP – does not include the Partnership Promise and no funds from the state. Employees may fund the HSA *New enrollees with coverage effective dates Sept 2 through Dec 1, 2016, will not receive a state contribution in 2016. This plan is only available to state and higher education active employees. www. partnersforhealthtn. gov 1 -800 -253 -9981 14

Health Benefits With the Health. Savings CDHP options you have: • Comprehensive health insurance coverage • Lower monthly premiums but a higher deductible • • • A tax-free HSA – which you own To meet your deductible before the plan starts paying for covered expenses No separate deductible or out-of-pocket maximum for pharmacy Coinsurance after you meet your deductible Lower total out-of-pocket maximum compared to PPOs www. partnersforhealthtn. gov 1 -800 -253 -9981 15

Health Benefits www. partnersforhealthtn. gov 1 -800 -253 -9981 16

Health Benefits Difference Between PPOs and Health. Savings CDHPs: *New enrollees with coverage effective dates Sept. 2 through Dec. 1, 2016 – the state will not contribute funds to your HSA in 2016. www. partnersforhealthtn. gov 1 -800 -253 -9981 17

Health Benefits CDHP Enrollment Restrictions • You cannot be enrolled in another plan, including a PPO, spouse’s plan or any government plan (Medicare, Medicaid, TRICARE). • Eligible for VA medical benefits but you did not receive benefits during the preceding three months, you can enroll in and make contributions to your HSA. • If you receive VA benefits in the future, then you are NOT entitled to contribute to your account for another three months. • You can’t be claimed as a dependent by someone else. • For other restrictions go to IRS. gov. www. partnersforhealthtn. gov 1 -800 -253 -9981 18

Health Benefits What are the benefits of a HSA? • The money in your HSA (yours and employer contributions) rolls over each year • Use money in your account to pay deductible and qualified expenses including some not covered by the CDHP (i. e. vision and dental, hearing aids, acupuncture etc. ) • The money is yours! Take it with you if you leave, retire or change plans • The HSA offers tax advantages on money in your account: 1. Both employer and employee contributions are tax free 2. Withdrawals for qualified medical expenses are tax free 3. Interest earned is tax free • HSA is a retirement savings account option. www. partnersforhealthtn. gov 1 -800 -253 -9981 19

Health Benefits How does the HSA work? • You can contribute pre-tax money into your account and then use the funds for qualified medical expenses or save for future expenses. • You cannot fund or use your HSA if you or your spouse have funds in a medical FSA the same year. Allowable maximum contribution: You can contribute to your HSA up to the annual IRS allowable maximums: Ø In 2016, IRS guidelines allow total tax-free contributions up to $3, 350 for individuals and $6, 750 for families annually. Ø At age 55 and older, you can make an additional $1, 000/year contribution ($4, 350 for individuals or $ 7, 750 for families). Ø If the state contributes money to your account, it counts toward the maximum. www. partnersforhealthtn. gov 1 -800 -253 -9981 20

Health Benefits Pay. Flex – Health Savings Account • If you choose to enroll in a Health. Savings CDHP, a health savings account is automatically opened for you. • Pay. Flex will send you a letter asking for additional information • Then, you will receive a debit card from Pay. Flex. • Register and access your Pay. Flex HSA online at www. stateoftn. payflexdirect. com www. partnersforhealthtn. gov 1 -800 -253 -9981 21

Health Benefits Pay. Flex – Health Savings Account • Use the Pay. Flex Card • Convenient way to pay for eligible expenses • Expenses paid automatically • Keep your receipts for audit purposes • Pay yourself back • Pay for eligible expenses with cash, check or personal credit card • Withdraw funds for your HSA to pay yourself back • Or have payment deposited directly to checking or savings account • Pay your provider • Use Pay. Flex’s online feature to pay provider • Contribute post-tax dollars from your bank account online www. partnersforhealthtn. gov 1 -800 -253 -9981 22

Health Benefits Pay. Flex – Health Savings Account • Pay. Flex free mobile app • Manage and access your account 24/7 • Available for most mobile digital devices • Upload photos of receipts for tax purposes • Earn interest and invest your money • Earn tax free interest on your HSA • When account reaches $1, 000 – can invest the funds over this amount • Account fees: The state pays the monthly HSA maintenance fee while you’re enrolled in a Health. Savings CDHP. You are responsible for standard banking fees. If you leave your job, retire or choose a PPO option in the future, you will be responsible for paying any applicable HSA fees. www. partnersforhealthtn. gov 1 -800 -253 -9981 23

2016 Partnership Promise • Employees who enroll in the Partnership PPO or the Wellness Health. Savings CDHP pay lower premiums and costs by agreeing to complete simple steps for better health. These steps are called the Partnership Promise. • The Partnership Promise is an annual commitment, but you are not required to sign a new promise each year. • You and all eligible family members must enroll in the same healthcare option. Your dependent spouse must also agree to the Partnership Promise. • Children are not required to complete the steps. • Healthways administers the Partnership Promise. • Requirements may change each year. www. partnersforhealthtn. gov 1 -800 -253 -9981 24

Goal of the Partnership Promise Offers tools and health coaches to help you get and stay healthy: • Lose weight • Eat healthy • Increase exercise • Quit tobacco. Members who participate in the Partnership Promise are also rewarded with lower rates and lower costs for service. www. partnersforhealthtn. gov 1 -800 -253 -9981 25

Partnership Promise – 2016 New Members 2016 new members and covered spouses must: 1. Complete the online Well-Being Assessment (WBA) o partnersforhealthtn. gov and click on the “My Wellness Tab” 2. Get a biometric health screening from your physician o Includes height, weight, blood pressure, waist circumference, glucose and cholesterol levels • Steps 1 and 2 must be completed within 120 days from the day your coverage begins. www. partnersforhealthtn. gov 1 -800 -253 -9981 26

Choosing an Insurance Carrier • Once you select your plan, select either: • Blue. Cross Blue. Shield of Tennessee Network S • Cigna Local. Plus Network • Check the networks carefully to make sure your preferred doctors and hospitals are in the network you choose www. partnersforhealthtn. gov 1 -800 -253 -9981 27

Choosing Your Premium Level • Four premium levels (tiers) available: • Employee Only • Employee + Child(ren) • Employee + Spouse + Child(ren) Remember: Partnership PPO premiums are lower than the premiums for the Standard PPO Wellness Health. Savings CDHP premiums are lower than the Health. Savings CDHP premiums www. partnersforhealthtn. gov 1 -800 -253 -9981 28

Choosing Your Premium Level • If your spouse works for a local government or education agency whose health insurance is through the State • You can choose premium level, health option and insurance carrier separately • If you and your spouse are both State and Higher Education employees: • Consider employee only coverage or employee + child(ren) to receive the maximum life insurance benefit. NOTE: An individual may only be covered under one state policy www. partnersforhealthtn. gov 1 -800 -253 -9981 29

Premiums: State Plan Employee Share of Monthly Premiums Premium Level Partnership PPO Standard PPO Wellness Health. Savings CDHP Employee Only $118. 50 $143. 50 $81. 00 Employee + Child(ren) $177. 74 $202. 74 $122. 50 Employee + Spouse $248. 84 $298. 84 $170. 50 Employee + Spouse + Child(ren) $308. 09 $358. 09 $212. 00 The State pays 80 percent of the total premium cost for active State and Higher Education employees. www. partnersforhealthtn. gov 1 -800 -253 -9981 30

In-Network Deductibles and Outof-Pocket Maximums *New enrollees with coverage effective dates Sept. 2 through Dec. 1, 2016 – the state will not contribute funds to your HSA in 2016. *See eligibility guide for more detail on out-of-network costs www. partnersforhealthtn. gov 1 -800 -253 -9981 31

Free In-Network Preventive Care If provided in-network, free preventive care includes: · Flu and pneumococcal vaccinations · Annual physical exam · Annual well-woman visit · Osteoporosis screening for women · Screenings for colon, breast or cervical cancer Regular preventive care is one of the most important things you can do to stay healthy. www. partnersforhealthtn. gov 1 -800 -253 -9981 32

Take Note! • Deductibles and out-of-pocket maximums for in-network and out-of-network services add up separately in PPOs and CDHPs. Example – Partnership PPO • In-network services count toward In-Network in-network deductible and out-of-pocket maximum • Out-of-network services count toward out-of-network deductible and out-of-pocket maximum Out-of-Network Deductible Out-of-Pocket Max $450 $2, 300 Deductible Out-of-Pocket Max $800 $3, 500 Ineligible expenses, including non-covered services and expenses over the MAC don’t count toward deductibles and out-of-pocket maximums. www. partnersforhealthtn. gov 1 -800 -253 -9981 33

Pharmacy Benefits CVS/Caremark is the pharmacy benefits manager for all plan members Ø Covered drug list is the same for both the PPOs and CDHPs Ø More than 67, 000 independent and chain pharmacies throughout the U. S. Ø 90 -day supply of approved maintenance drugs is available at discounted rates • About 916 Tennessee pharmacies fill 90 -day prescriptions in the Retail 90 Network Tobacco Cessation: The state’s prescription drug coverage provides free tobacco quit aids to members who want to stop using tobacco products. www. partnersforhealthtn. gov 1 -800 -253 -9981 34

Prescription Drug Copays Partnership PPO Standard PPO Wellness Health. Savings CDHP In-Network Out-of. Network In. Network Out-of. Network 30 -Day Supply (only from pharmacies in the 30 -day network) $5 copay generic $35 copay preferred brand $85 copay nonpreferred brand Copay, plus any amount exceeding MAC $10 copay for generic $45 copay for preferred brand $95 copay for nonpreferred brand Copay, plus any amount exceeding MAC After deductible is met 20% coinsurance After deductible is met 40% coinsurance plus amount exceeding MAC After deductible is met 30% coinsurance After deductible is met 50% coinsurance plus amount exceeding MAC 90 -Day Supply (90 -day network pharmacy or mail order) $10 copay generic $65 copay preferred brand $165 copay non-preferred brand Copay, plus any amount exceeding MAC $20 copay for generic $85 copay for preferred brand $185 copay for nonpreferred brand Copay, plus any amount exceeding MAC After deductible is met 20% coinsurance N/A – no network After deductible is met 30% coinsurance N/A – no network Copay, plus any amount exceeding MAC 10% coinsurance without first having to meet deductible N/A – no network 20% coinsurance without first having to meet deductible N/A – no network $5 copay Copay, plus $10 copay 90 -Day Supply generic any amount generic (certain exceeding $30 copay $40 copay maintenance MAC preferred brand preferred medications from brand 90 -day pharmacy $160 copay $180 copay non-preferred or mail order) www. partnersforhealthtn. gov 1 -800 -253 -9981 brand non- 35

Employee Assistance Program (EAP) – Free Included for every employee eligible for medical benefits. You and your dependents receive EAP benefits even if you do not participate in the State Group Insurance Program. EAP can help with: Family or relationship issues Child and elder care Feeling anxious or depressed Difficulties and conflicts at work Dealing with addiction Grief and loss Legal or financial issues Work/life balance • Services are free, confidential and available to members 24/7 • You and your eligible dependents - get up to five, free counseling sessions per problem episode, per year • Toll Free 24/7 at 1. 855. HERE 4 TN (1. 855. 437. 3486) • Or at www. Here 4 TN. com www. partnersforhealthtn. gov 1 -800 -253 -9981 36

Behavioral Health and Substance Abuse Treatment All members of state health plans have behavioral health and substance abuse treatment benefits through Magellan Health • Call 1. 855. HERE. 4. TN (1. 855. 437. 3486) or www. here 4 tn. com • Services include: • • Outpatient assessment and treatment • Inpatient assessment and treatment • Alternative care (partial hospitalization, residential or intensive outpatient treatment) • Treatment follow-up and aftercare Prior authorization is required for some services www. partnersforhealthtn. gov 1 -800 -253 -9981 37

Optional Dental Benefits Eligible employees can choose between two dental options: Cigna Prepaid Plan Met. Life Dental Preferred Plan • Fixed Copays • Coinsurance and deductibles • Participating dentists only • Any dentist • Pay less with network providers • Eligible employees can enroll in one of two options • Dental insurance premium is paid 100 percent by the employee www. partnersforhealthtn. gov 1 -800 -253 -9981 38

Prepaid Plan Administered by Cigna The network is Cigna Dental Care (HMO) Services provided at set copay amounts from limited network • Must select a dentist from the Prepaid Plan list and notify Cigna • Some areas in state where network dentists are not available • Must use selected dentist to receive benefits • No deductible, no claims and no waiting period • Referrals are not required www. partnersforhealthtn. gov 1 -800 -253 -9981 39

Dental Preferred Provider Organization (DPPO) Plan administered by Met. Life. The network is PDP. The DPPO plan provides services with member coinsurance rates • Choose any dentist (maximum benefits when visiting an in-network Met. Life DPPO provider) • Pay co-insurance for covered services • Deductible applies for basic and major covered services for in and out of network providers • • • You or dentist file claims for covered services Referrals not required Some services require a 6 -month waiting period Orthodontic services require a 12 -month waiting period Some limitation and exclusions apply www. partnersforhealthtn. gov 1 -800 -253 -9981 40

Dental Premiums Prepaid Plan DPPO Plan Employee Only $12. 61 $21. 51 Employee + Child(ren) $26. 18 $49. 46 Employee + Spouse $22. 35 $40. 69 Employee + Spouse + Child(ren) $30. 73 $79. 62 Dental services for both the Prepaid Plan and the Dental PDO include: • Periodic oral evaluations • Routine Cleanings • Amalgam fillings • Endodontic – Root Canal • X-rays • Extractions • Major restorations • Orthodontics • Dentures www. partnersforhealthtn. gov 1 -800 -253 -9981 41

Optional Vision Benefits Administered by Eye. Med Vision Care • Plan options: Basic Plan Expanded Plan • Discounted rates • Co-pays • Allowances • Discounted rates • Both plans offer the same services www. partnersforhealthtn. gov 1 -800 -253 -9981 42

Vision Premiums • Monthly premiums for Active Members: Premiums Basic Plan Expanded Plan Employee Only $3. 35 $5. 86 Employee + Child(ren) $6. 69 $11. 72 Employee + Spouse $6. 35 $11. 14 Employee + Spouse + Child(ren) $9. 83 $17. 23 • Eye. Med offers some additional discounts Each year during Annual Enrollment, eligible employees can enroll in or transfer between vision options. www. partnersforhealthtn. gov 1 -800 -253 -9981 43

Additional Benefits • State employees are also eligible for: • • • Par. TNers for Health Wellness Program Life Insurance Long-Term Care Insurance Sick Leave Bank Flexible Benefits Deferred Compensation www. partnersforhealthtn. gov 1 -800 -253 -9981 Did You Know? All State employees have access to the Par. TNers for Health Wellness Program even if enrolled in the Standard PPO or Health. Savings CDHP. 44

Par. TNers for Health Wellness Program • The Par. TNers for Health Wellness Program is FREE to all health insurance plan members, eligible spouses and dependents • Wellness Resources: • Coaching • Well-Being Assessment (WBA) • Nurse Advice Line • Wellness Challenges • Weight Watchers at Work discounts and Fitness Center discounts • Weekly health e-tips Visit wellness webpage on the Par. TNers for Health website to access www. partnersforhealthtn. gov 1 -800 -253 -9981 45

Working for a Healthier Tennessee ØExpands wellness resources to all employees ØEncourages state employees to lead healthier lives by focusing on: 1. Physical Activity 2. Healthy Eating 3. Tobacco Cessation www. partnersforhealthtn. gov 1 -800 -253 -9981 46

Basic Term Life and Accidental Death and Dismemberment • The State provides free to all full-time employees: • $20, 000 of basic term life insurance • $40, 000 of basic accidental death and dismemberment (AD&D) • If you are enrolled in health insurance as the head of contract, your coverage automatically increases with your salary up to: • $50, 000 for term life insurance • $100, 000 for AD&D insurance • If you enroll in family health insurance, your enrolled dependents are covered for $3, 000 of basic term life coverage and basic AD&D based on your salary and family composition. Coverage effective date is the same as health insurance. www. partnersforhealthtn. gov 1 -800 -253 -9981 47

Optional Accidental Death & Dismemberment Insurance • Accidental death and dismemberment protection for yourself and your dependents • Coverage is available at low group rates – no questions asked • Premiums vary by salary • You may enroll as a new employee or during Annual Enrollment • The maximum benefit available to employees is $60, 000 • Enroll through ESS Basic Term Life, Basic AD&D and Optional AD&D are administered by Minnesota Life. www. partnersforhealthtn. gov 1 -800 -253 -9981 48

Optional Term Life Insurance • Premiums are based on age and the amount of coverage requested • Coverage is also available for spouses and dependent children Spouses: Maximum level of coverage is $30, 000 Ø Children: $5, 000 or $10, 000 term rider Ø • Must enroll in first 31 days of employment for guaranteed issue coverage. Effective after three full months of employment. • You can apply later during Annual Enrollment by answering health questions • Select up to five times your annual base salary when first eligible Ø Ø • Minimum coverage level: $5, 000 Maximum coverage level: $500, 000 Enroll through Minnesota Life website at lifebenefits. com/stateoftn Optional Term Life Insurance is administered by Minnesota Life. www. partnersforhealthtn. gov 1 -800 -253 -9981 49

Long-Term Care Insurance • Long-Term Care Insurance is administered by Med. America • Covers services for individuals no longer able to care for themselves: • Nursing home care • Assisted living • Home healthcare • Home care • Adult Day Care • You have 90 days to enroll with guaranteed-issue coverage • Your spouse, dependent children, parents and parents-in-law may also apply • Premiums are based on age of the insured at the time of enrollment www. partnersforhealthtn. gov 1 -800 -253 -9981 50

Sick Leave Bank • Administered by Tennessee Department of Human Resources • Provides sick leave to qualifying members • A member may receive a maximum of 90 days from the Bank • You must be employed for at least 12 months and have at least six days of sick leave as of Oct. 31 to enroll • Initially, four days of sick leave are deducted and donated to the Bank. The member must be employed full-time and in leave accruing status • A minimum of one day will be deducted on Oct. 1 each subsequent year • New members are eligible to apply for grants of sick leave on Feb. 1 following enrollment. • To learn more, visit www. tn. gov/dohr/employees/sickleave. html www. partnersforhealthtn. gov 1 -800 -253 -9981 51

Flexible Benefits (FSAs) • Lower your taxes • Available to all State employees • Reimburses you for qualified expenses from pre-tax income by enrolling in one of the following reimbursement accounts: • • Medical expenses Dependent care expenses Parking expenses Transportation expenses • Fill out a reimbursement form for eligible charges and money is deposited into your bank account when expense is approved. • Flexible Spending Accounts are tied to the insurance coverage effective date. FSA benefits will begin the same date as insurance coverage. www. partnersforhealthtn. gov 1 -800 -253 -9981 52

Hybrid Pension Plan • New hires with the State will be enrolled in the Hybrid Pension Plan • Employees transferring from the State, Higher Education or a Local Education Agency as a K-12 teacher will be grandfathered into the legacy plan • Employees transferring from local government will be treated as a new hire • The Hybrid Pension Plan contains both a Defined Benefit and a Defined contribution component • Defined benefit component is administered by TCRS • Defined contribution component is administered by Empower Retirement • Shared risk by Employer and Employee • Employees are required to contribute to the plan Go to treasury. tn. gov/dc for more information 53

Enrolling in Benefits • All State employees must enroll using Edison Employee Self Service (ESS) for health, dental and vision coverage and optional accidental death & dismemberment insurance • Enrollment must be completed within 31 days of your hire date • Any required dependent verification must also be submitted during this timeframe • Example dependent verification documents include: • Federal Income Tax Return for a spouse • Birth certificate for a child To enroll in optional benefit products such as life insurance, use the separate enrollment forms provided by your ABC. www. partnersforhealthtn. gov 1 -800 -253 -9981 54

Online Enrollment through ESS To select your health insurance and other benefit options: • Log on to Edison » www. edison. tn. gov » Use username and temporary password provided by your Human Resource office » Go to Employee Self Service > Benefits Enrollment » Click SELECT » Follow the prompts • If covering dependents, submit dependent verification by: » Uploading electronic documentation » Faxing documentation to Benefits Administration service center www. partnersforhealthtn. gov 1 -800 -253 -9981 55

When Will Coverage Begin? • Health, dental, vision and basic term life/AD&D coverage begin on the first day of the month after one full calendar month of employment from your hire date • If you are hired on Sept. 15, coverage would begin on Nov. 1 • Optional Term Life coverage begins after three full calendar months from employment/eligibility • Optional Long-Term Care effective date is included with the Certificate of Coverage issued by Med. America • Ask your ABC if you have questions about when your coverage begins www. partnersforhealthtn. gov 1 -800 -253 -9981 56

When Are Premiums Paid? • Your ABC will tell you when your premiums will be deducted from your paycheck • Enter your benefit selections in ESS or submit your enrollment forms to your ABC as soon as possible. • If you do not enter your benefit selections early, in some instances you could end up with a double deduction from your paycheck the first month of enrollment. www. partnersforhealthtn. gov 1 -800 -253 -9981 57

When Will My ID Cards Arrive? • Within three weeks of the date your application is processed Blue. Cross Blue. Shield Cigna • Sends up to two ID cards automatically, both with member’s name • Sends separate ID cards for each insured family member with each participant’s name • These may be used by any covered dependent • There may be up to four ID cards in each envelope • CVS/Caremark will send separate ID cards for pharmacy benefits • If you enroll in dental or vision benefits, you will receive your ID cards within three weeks www. partnersforhealthtn. gov 1 -800 -253 -9981 58

Retiree Insurance • Retiree health insurance coverage (pre-65 retirees) is not available to employees whose employment first began on or after July 1, 2015. • Medicare supplement insurance will not be available to any employee whose first employment is on or after July 1, 2015. • Any senator, representative or governor if first elected to office after July 1, 2015, is not eligible to continue coverage after retirement from office. • Any employee whose first state employment began before July 1, 2015, and who returns to state service after July 1, 2015, will not be prohibited from retiree coverage if the employee did not accept a lump sum payment from TCRS before July 1, 2015. Employees must also meet all other retiree insurance eligibility requirements. www. partnersforhealthtn. gov 1 -800 -253 -9981 59

Your Privacy • Your personal health information is strictly confidential • Your health privacy rights are protected through a federal law called “HIPAA” • Benefits Administration can only discuss benefits information with the head of contract (HOC) • The Authorization for Release of Protected Health Information form must be completed before Benefits Administration can discuss benefits information with your spouse or other authorized representative To print and complete a release form, visit www. tn. gov/finance/section/fabenefits. On this page, select the “Forms” tab. www. partnersforhealthtn. gov 1 -800 -253 -9981 60

Insurance Carrier Websites • Blue. Cross Blue. Shield, Cigna and CVS/caremark each offer member websites that allow you to: • View detailed information about your claims • Print temporary ID cards • Access other helpful member services Ø Blue. Cross Blue. Shield Ø Cigna www. bcbst. com/members/tn_state/ www. cigna. com/site/stateoftn Ø CVS/caremark www. info. caremark. com/stateoftn www. partnersforhealthtn. gov 1 -800 -253 -9981 61

Who to Contact • Your primary point of contact is your Agency Benefits Coordinator (ABC) • For questions about a provider or insurance claim, contact your insurance carrier directly via the carrier’s member website or the number on the back of your ID card • For questions about eligibility and enrollment, call the Benefits Administration service center at 1 -800 -253 -9981 • Par. TNers for Health www. partnersforhealthtn. gov • Benefits Administration tn. gov/finance/section/fa-benefits 1 -800 -253 -9981 62

Thank you for your attention during this presentation. More information is available at tn. gov/finance/section/fa-benefits If you have questions, please ask your Agency Benefits Coordinator at this time. 63